Universität zu Köln

Forbrig, Robert ORCID: 0000-0002-1054-1463, Lockau, Hannah, Flottmann, Fabian, Boeckh-Behrens, Tobias, Kabbasch, Christoph, Patzig, Maximilian, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Fiehler, Jens, Liebig, Thomas, Thomalla, Goetz, Onur, Oezguer A., Wunderlich, Silke, Kreiser, Kornelia ORCID: 0000-0002-6823-5493, Herzberg, Moriz, Wollenweber, Frank A., Prothmann, Sascha and Dorn, Franziska ORCID: 0000-0001-9093-8307 (2019). Intracranial Rescue Stent Angioplasty After Stent-Retriever Thrombectomy Multicenter Experience. Clin. Neuroradiol., 29 (3). S. 445 - 458. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1869-1447

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Abstract

Purpose Stent-retriever thrombectomy (SRT) for acute intracranial large artery occlusion (LAO) may not result in permanent recanalization in rare cases, e.g. due to an underlying stenosis or dissection. In this specific patient group, rescue stent angioplasty (RSA) may be the only treatment option to achieve permanent vessel patency and potentially a good clinical outcome. To date, the experience with RSA is limited. Methods In this retrospective analysis, interventional and clinical data of patients with acute intracranial LAO of the anterior and posterior circulation who underwent RSA after SRT due to an underlying lesion between 2012-2017 in four neurovascular centers were studied. Results In this study 34 patients (mean age 67 years) were included whereby 18 patients had anterior circulation LAO and 16 patients posterior circulation LAO. The SRT maneuver count ranged between 1 and 15 (median 2). Indications for RSA were an immediate re-occlusion in 25 (74%), and a persistent high-grade stenosis in 9 patients (26%). The RSA was technically feasible in 33 patients (97%). A mTICI 2b/3 result was obtained in 26 patients (76%). Median onset-to-recanalization time was 248min (range 80-650min). After 3 months 10/34 patients (29%) had a good clinical outcome (modified Rankin Scale, mRS 0-2). In detail, 4/18 patients (22%) with anterior circulation LAO and 6/16 patients (38%) with posterior circulation LAO were functionally independent. Conclusion The use of RSA can be considered for acute intracranial LAO in cases with immediate re-occlusion or high-grade stenosis after SRT alone.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Forbrig, Robert UNSPECIFIED orcid.org/0000-0002-1054-1463 UNSPECIFIED Lockau, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Flottmann, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Boeckh-Behrens, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Patzig, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Fiehler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Thomalla, Goetz UNSPECIFIED UNSPECIFIED UNSPECIFIED Onur, Oezguer A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wunderlich, Silke UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreiser, Kornelia UNSPECIFIED orcid.org/0000-0002-6823-5493 UNSPECIFIED Herzberg, Moriz UNSPECIFIED UNSPECIFIED UNSPECIFIED Wollenweber, Frank A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Prothmann, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorn, Franziska UNSPECIFIED orcid.org/0000-0001-9093-8307 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-142573
DOI:	10.1007/s00062-018-0690-4
Journal or Publication Title:	Clin. Neuroradiol.
Volume:	29
Number:	3
Page Range:	S. 445 - 458
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1869-1447
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; BASILAR ARTERY-OCCLUSION; MECHANICAL THROMBECTOMY; ENDOVASCULAR TREATMENT; SOLITAIRE DEVICE; SINGLE-CENTER; THERAPY; RECANALIZATION; RECOMMENDATIONS; ALTEPLASE Multiple languages Clinical Neurology; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14257